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General NPI Number Information
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NPI Number | 1417284811
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Entity Type | Individual
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Provider Name | VIREL R PRAJAPATI PA-C
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Gender | Male
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Dates
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Enumeration Date | 11/06/2009
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Last Update Date | 11/06/2009
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Provider Practice Location Address
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Address Line | 865 STONE ST
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City | RAHWAY
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State | NJ
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Zip | 07065-2742
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Country | US
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Telephone | 732-381-4949
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Fax |
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Provider Business Mailing Address
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Address Line | 1302 ROBERTS WAY
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City | VOORHEES
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State | NJ
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Zip | 08043-2061
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Country | US
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Telephone | 609-217-1847
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00228300
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License Number State | NJ
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